Shame, Body Image, and Body Dysmorphia

Body image concerns are among the most common yet least openly discussed sources of psychological distress. For many people, discomfort with their appearance is accompanied by deep feelings of shame, self-criticism, and disconnection. In a culture that places high value on appearance, the body can become a focal point for judgment rather than care.

Body Image and the Development of Shame

Our relationship with our body is often shaped through early attachment experiences, how emotions are responded to, and whether the body is treated as safe, acceptable, and worthy of care. Over time, cultural messages about attractiveness, gender, weight, and worth can become internalised, reinforcing the belief that appearance determines value. When these messages are introjected, body dissatisfaction often shifts into shame or feelings of defectiveness —the painful sense that

“there is something wrong with me.” Shame differs from dissatisfaction in that it targets the self, not just the body. It can lead to hiding, perfectionism, avoidance, or relentless self-monitoring.

When the Body Becomes the Problem

For some individuals, distress about appearance becomes persistent and consuming. Body Dysmorphic Disorder (BDD) involves ongoing preoccupation with perceived flaws that are minor or unnoticeable to others. This preoccupation can significantly interfere with daily life and may include behaviours such as mirror checking, reassurance seeking, skin picking, or avoiding social situations. BDD is not vanity. It is a condition closely linked with anxiety, obsessive thinking, and shame. Individuals often feel misunderstood, embarrassed, or reluctant to seek help due to fear of being dismissed or not believed in their distress.

The Role of Trauma and the Nervous System

Body shame and dysmorphia are often connected to experiences where the body was criticised, objectified, unsafe, or out of one’s control. Trauma, bullying, medical experiences, chronic illness, and social stigma can all disrupt a person’s sense of safety within their body. When the nervous system remains in a state of threat, attention can become hyper-focused on the body as a way of attempting to regain control.

This can intensify distorted perception and self-criticism, reinforcing cycles of shame and distress.

A Compassionate Therapeutic Approach

I have worked extensively with both men and women who have experienced feelings of shame, unworthiness, and anxiety about their appearance and body for a number of reasons. I offer a space to gently explore body image and shame without judgement; a space where we can understand together where body-related beliefs developed, reduce shame, strengthen emotional regulation, and rebuild a sense of safety and connection with the body. Rather than aiming for forced body positivity, my approach offers a more realistic and sustainable goal: moving from self-criticism toward care and self-compassion.

If shame or distress about your body is affecting your mental health, please feel free to reach out to me today for a 15-minute obligation-free phone call or via email enquiries@elysiabullen.com.au to get the conversation started today.

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